Active NPI
Jennifer Evenson Christeson, LCSW
- Clinical Social Worker
- Simi Valley, CA
National Provider Identifier
1881856235
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 18619
- Practice address
- 2975 Sycamore Dr
Simi Valley, CA 93065-1201 - Phone
- (805) 758-3257
- NPI assigned
- Jun 26, 2008
- Last updated
- Jul 25, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 18619 | CA | Primary |
Addresses
Primary practice location
2975 Sycamore Dr
Simi Valley, CA 93065-1201
Mailing address
5936 Palomar Cir
Camarillo, CA 93012-4321
Phone (805) 758-3257
Other practice location 1
2925 Sycamore Dr Ste 105
Simi Valley, CA 93065-1208
Phone (805) 955-0532
Other names 1
- Jennifer Lynn Evenson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18619 | CA | MD | Sports Physician Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ebrahim Hazany MD a Medical Corporation | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Cope Clinic Inc.
- Adult Mental Health Clinic/Center
- Newbury Park, CA
- NPI 1104929082
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1214438400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1564012800000",
"number": "1881856235",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5936 PALOMAR CIR",
"city": "CAMARILLO",
"state": "CA",
"postal_code": "930124321",
"telephone_number": "805-758-3257"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2975 SYCAMORE DR",
"city": "SIMI VALLEY",
"state": "CA",
"postal_code": "930651201",
"telephone_number": "805-758-3257"
}
],
"practiceLocations": [
{
"address_1": "2925 Sycamore Dr Ste 105",
"address_purpose": "LOCATION",
"city": "Simi Valley",
"state": "CA",
"postal_code": "930651208",
"country_code": "US",
"telephone_number": "805-955-0532",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CHRISTESON",
"first_name": "JENNIFER",
"middle_name": "EVENSON",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-06-26",
"last_updated": "2019-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "CA",
"license": "18619",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "EVENSON",
"middle_name": "LYNN",
"credential": "LCSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Simi Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.